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Understanding your cycle and timing for conception

There’s a lot of conflicting advice out there about how to increase your chance of conceiving. The piece of advice most often given is “get your timing right” – but what does that mean?

How do you know when the best time is to be having sex for conception and what do you need to know about your cycle?

A recent survey by Virtus Health revealed a staggering 74 per cent of women don’t know when in their cycle is the optimal time to conceive. While timing isn’t the sole factor, it is one of the most important. Knowing when you ovulate and your most fertile time can certainly improve your chances of becoming pregnant.

Your cycle demystified…

Understanding your cycle is the key to getting your timing right. Let’s break it down and look at what happens during each stage.

Menstruation: Days 1 – 5

Day 1 of your cycle is the first day of your period, meaning the first day of full flow (spotting doesn’t count). During this time, the uterus sheds its lining from the previous cycle. Between days 1 – 5 of your cycle, new follicles (sacs of fluid containing eggs) begin to develop within your ovaries.

Days 5 – 12

The body selects a follicle to develop and the dominant follicle begins to secrete oestrogen which in turn increases the thickness of the uterine lining, preparing it for pregnancy.

Ovulation: Days 12 – 15

The pituitary gland releases a surge of luteinising hormone (LH), triggering the release of the mature egg from the ovary and into the fallopian tube. Sperm can survive for up to 2 – 3 days in the fallopian tubes waiting for the arrival of the egg for fertilisation, however the egg has a window of approximately 12-24 hours in which it can be fertilised after release. The dominant follicle that has released the egg then forms the corpus luteum. This important structure releases progesterone (and oestrogen) which assist in maintaining the uterine lining.

Days 16 – 28

If the egg is fertilised, the embryo (fertilised egg) travels into the uterus and implants in the lining of the uterus. Once implanted, the embryo begins to produce Human Chorionic Gonadotrophin (hCG). This drives the corpus luteum to continue production of progesterone to support the pregnancy.

If no fertilisation has occurred, the egg is absorbed by the body, the corpus luteum degenerates, progesterone levels fall and the uterine lining breaks down, restarting the menstrual cycle.

What if my cycle is longer or shorter than 28 days?

A typical menstrual cycle is 28 days (or at least somewhere between 26 and 32 days), with ovulation occurring halfway through the cycle. The second half of the menstrual cycle is fixed at approximately 14 days, so a woman can count back from her last period to see when she ovulated. So if your cycle is longer, e.g. 35 days, you’ll probably ovulate later too – around day 21. If your cycle is shorter, e.g. 25 days, you’ll probably ovulate earlier – around day 11.

When should we be having sex?

Sex should be a fun and intimate activity, however many couples trying to conceive find that it can become a ‘chore’.

To reduce the stress associated with getting the timing right try to focus less on the day of suspected ovulation and instead make sure you are having regular sex – about every two days in the week around ovulation (around 2 weeks before your next period is due). For example, a woman with a 28 day cycle is best to have regular sex between day 11 and 17 of her cycle.

When should we seek advice?

I’d recommend seeing a fertility specialist if you’re under 35 and have been trying to conceive for over 12 months, or after six months if you’re over 35 years of age.

Other symptoms that may indicate a fertility issue are significant pain or discomfort throughout your cycle, heavy periods or an irregular cycle. If these symptoms are present, then it may be worthwhile seeing a fertility specialist sooner as there may be an underlying medical issue which could cause an avoidable delay in conceiving.

To calculate when you're likely to be ovulating, try our Ovulation Calculator:

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I was recently asked to comment in a Sun Herald article on 26th August (also published online here: Sydney Morning Herald) on Collette Dinnigan, who pregnant at the age of 46, has called on women not to leave it too long to try for a baby.

It is always news when a high profile personality such as Ms Dinnigan, has a child, particularly when the personality in question is a bit older. The difficulty is that these occasions, while very happy for the people involved, give a misleading picture of the actual likelihood of conception in these circumstances. Remember that high profile personalities such as Ms Dinnigan, are human beings who quite rightly value their privacy and so very rarely (quite understandably) talk to the press when things aren’t going so well. It was therefore, a particularly courageous action of Ms Dinnigan, while celebrating her own happiness, to so publicly, point out the difficulties that may face other women, seeking the same fulfilment.

What then, are the issues for women in their forties who are planning to have a child?

The main difficulty is that conceiving is simply harder at that age and, even once a woman does conceive, the risk of miscarriage is higher. Surprisingly, although we have very good data about the effects of age on IVF conception (more shortly), we don’t have very good statistics about the effects of age on conceiving naturally. The limited available data about natural conception comes from old population studies or studies of unique populations, such as the Hutterites of North America, who do not use contraception. Interestingly these data, such as they are, seem to be entirely consistent with the more modern and abundant IVF data. Generally, in one year of trying, 75% of women under 30 years and 66% of 35-year-old women but only 44% of 40-year-old women will achieve a live baby naturally.

The main explanation for this, is that women are born with a finite number of eggs, and from that moment onwards, the number of eggs is declining all the time, until women go through their menopause at around 50-51. Nonetheless, women in their 40s do still ovulate each month. What is it about their eggs that cause all these problems?

A common misunderstanding with some women is that the fact she looks and feels young, and leads a healthy lifestyle, means that her eggs will be healthier. I regularly see women who have taken enormous care with their fitness and their health. The rest of their body is in great shape, completely fit and ready to carry that longed-for pregnancy. Sadly, despite this, the eggs still can’t do it. The effects of time are remorseless and, sadly, there is no wonder drug to fix it.

Scientists have shown that eggs from older women are more likely to have an abnormal makeup making pregnancy less likely, miscarriage more common and increasing the risk of Down Syndrome, a condition where a child is born with an extra chromosome number 21.

Nor is IVF a cure for this problem. For women, in their early 40s, IVF is still a good thing to try and gives significantly higher success rates than trying naturally. However, IVF success rates fall sharply after the age of 40 and by the time a woman is 45 are close to zero.

So, what’s the good news? Well despite all of the above, many women do conceive in their forties, either by IVF, or naturally, and have very happy healthy families. It is obviously better to have your family earlier, if you can, but all hope is not lost, just because you’re past 40. Conception and early miscarriage are the big problems but, if you do conceive and get past the first few weeks, by far the most likely outcome will be a healthy child. While the risk of Down Syndrome is increased, most of the other problems that affect young children are not increased by being conceived a later maternal age.

Finally, many women worry that by having their children later, their long term health and emotional development may be affected. On the contrary, we now know that the children of older mums grow up to be as healthy and bright as any other child.

There have been a number of happy and high profile stories in the press recently about older celebrities giving birth to healthy children. Stories like this used to be extraordinary, but they certainly seem to be on the increase. While this trend is supported by data that shows the fertility rate and numbers of births are increasing for women over 30 and especially for women in their early 40s, women and couples should understand the risks associated with having children later in life. IVF Australia, Melbourne IVF and Queensland Fertility Group, have teamed up to create their latest infographic - “Fertility and Age in Australia” which explores some of these issues.

Conceiving a baby in a same sex relationship

IVFAustralia, and its partner clinics Melbourne IVF, Queensland Fertility Group and TasIVF, are proud supporters of ‘rainbow families’. IVFAustralia were an Official Supporter of Sydney’s Gay and Lesbian Mardi Gras this year, and we’ve seen the number of same sex couples accessing our donor program double in the last year.

In 2011, a survey of 3,835 LGBT people found 33% of women and 11% of men had children1 - but close to 40% reported wanting to have children or have more children. This so-called ‘gayby’ boom is thanks to changes in community attitudes and laws, including better access to Assisted Reproductive Treatments for lesbian and single women.

So, if you’re hoping to experience the joy of starting a family within a gay or lesbian relationship, what do you need to consider?

How long will it take to conceive?

Generally speaking, we’d expect a healthy woman with no fertility issues to fall pregnant through IVF or Artificial Insemination within six months. You can prepare for pregnancy by improving your diet, doing regular exercise and other lifestyle factors.

When you access the donor program there are a few extra decisions you need to make.

Do you choose a known donor, or an anonymous donor? In a lesbian relationship, do you want to implant an embryo with eggs from one mother into the other? Should you store some sperm from the same donor for later, in case you’d like a related sibling? For two dads, the process of finding a surrogate can also be complex.

How do we choose a donor?

Our fertility clinics offer access to both Australian and US* donor sperm. The access fee for US donor sperm is higher, but the waiting list is also shorter as there is a shortage of local donors (gay men, we’d love to hear from you!)

When you’re using donor sperm or eggs, there are a few legal, emotional and ethical factors to consider and a counsellor will help you work through these concerns so you can make the best decisions for your family’s future.

Are there any legal issues?

Each state has different laws about parental recognition and access, so it’s worth seeking specialist advice before you start.

For example, in Victoria, the Victorian Assisted Reproductive Treatment Act (2008) removed discrimination against lesbian and single women with regard to fertility treatment, recognised parenting status for non-birth mothers and also effectively legalised ‘altruistic’ surrogacy. It also recognises lesbian couples as equal parents of their child or children as long as they were in a de facto relationship.

What else should we be prepared for?

30 years of research2 has shown that the children of same-sex parented families do just as well as the children of heterosexual parents socially, educationally, physically and emotionally.

The issues your children will face as they get older are just the same as the issues facing any children conceived using donor sperm or eggs: Where did I come from? Should I contact my donor? You need to be prepared for these questions at some point.

In the meantime, we hope we can help you fulfil your dream of having a baby, and that you will experience the joys of pregnancy, birth and parenthood.

What should be my next steps?

If you would like to learn more about the fertility treatments available for same-sex couples in your regions, visit one of our websites.

* IVFAustralia and Queensland Fertility Group patients only.

1 Leonard et al. (2012) Private Lives 2: The Second National Survey of the Health and Wellbeing of GLBT Australians, The Australian Research Centre in Sex, Health and Society, Melbourne2Rainbow Families Council of Victoria (2010) Rainbow Families and the Law, RFC, Melbourne, http://www.rainbowfamilies.org